ORIF Proximal Humerus Fracture
An open reduction internal fixation for a proximal humerus fracture involves making about an 8-10 cm incision in the front of the shoulder. The fracture is visualized and the bone fragments are put back in place. A metal plate with screws are inserted to bridge the bony fragments and secure them in place to allow the bone to heal in good alignment.
An approximately 8-10 cm incision is made over the front of the shoulder. The fracture pieces are identified and brought into a more anatomic position. A plate is fixated to the bone to support the fracture while the bone is healing. Fluoroscopy (X-ray beam) is used to confirm anatomic position of the pieces. The incision is then closed with absorbable sutures, and dressings are applied. The patient will wake up with a sling in place.
- This surgery is performed under general anesthesia with a nerve block.
- This surgery is usually outpatient, which means the patient generally goes home the day of surgery.
- Surgery typically lasts 1-1.5 hours.
- A sling will be fit at a preop appointment before surgery and will need to brought to surgery.
- The sling will be placed on the patient prior to waking up from anesthesia.
- The incisions will be closed with absorbable sutures, and a waterproof dressing will be applied. This should be left in place until the first postop appointment.
- The patient may shower right away as long as there is a good seal of the waterproof dressing.
- Patients with a displaced fracture
- Patients with poor bone quality that may lead to lower chance of healing
- Patients who desire a quicker return to sports and activity
Recovery following an open reduction internal fixation of a proximal humerus fracture is several months. Patients will be placed in a sling for 4 weeks after surgery. Patients are limited to elbow range of motion and pendulum exercises for this period of time. Physical therapy (PT) will start about 2 weeks after surgery and will last for a few months, depending on the progress that is made. Physical therapists follow a prescribed protocol outlined by Dr. Faulkner to regain range of motion and strength. Physical therapy and home exercises are a critical part of a patient’s outcomes and quality of life after surgery. The patient should expect to continue to improve with range of motion and strength up to 1 year after surgery, with most of the gains occurring within the first few months after surgery. The patient should plan on being seen in clinic about every 6 weeks for 3-4 months after the surgery for close monitoring and to ensure any questions are answered.
Dr. Faulkner is a wonderful, warm and caring human being and an amazing surgeon. He performed a proximal humerus bone (shattered shoulder and broken humerus) surgery on me that took 3 of what I imagine were very laborious hours. After placing a titanium plate and 9 screws in my shoulder, I could not be happier with the results. I have complete use of my arm. Prior to Dr. Faulkner's surgery, I was afraid I might not have use of my arm at all. He and his team could not have been more professional, attentive, and expert in providing care and treatment for me. This includes his office staff.
ORIF proximal humerus fracture
I broke my arm flying off my road bike at 20mph on 6/15/19. I had a 3 part proximal humerus fracture. (The ball of the shoulder was broken in half and the ball was broken off the top of the humerus bone) Dr Faulkner did my surgery on 6/20/19. He told me I may never swim again, that I may be in chronic pain, and my arm would not ever be the same. I am a 2x Ironman triathlete so hearing this was very disappointing. Well I am a Christian and I had a lot of people praying for me. I have a plate and 9 screws in my arm. But with an excellent surgeon (which is critical for this type of fracture), and excellent PT and putting in a lot of hard work, and a lot of prayer, I am completely healed. I should also mention I never had any nerve damage which can happen with this type of fracture. I was swimming 10 weeks after surgery. I was running shortly after that. With the help of my PT I was lifting weights and swimming 3 times/week for rehab. My arm is actually stronger now post fracture and surgery than it was before. I am riding my bike again as well. I would 100% recommend Dr Faulkner for this type of fracture repair. It will take a TON of hard work to get yourself back to normal but you can if you don't give up and believe you can be 100% again.
ORIF proximal humerus fracture
4 weeks. The sling should be removed at least 3x/day for elbow, wrist, and finger range of motion exercises as will be instructed.
No. Driving with a sling is considered driving impaired and could be subject to a citation.
Yes. Patients are usually unaware of their arm movements at night. The sling helps to ensure that the arm stays in a good position for healing.
Physical therapy typically starts 2 weeks after surgery.
2 days after surgery. You will have a waterproof dressing on that should be left in place until your first postoperative appointment.
The ice machine should be used for about 30 minutes at least 3 times a day until your first postop. You may ice more frequently if desired.
An anesthetic injection performed by the anesthesiologist to turn off pain signals that go to a targeted region.
This will be discussed at your preop appointment. If a narcotic is prescribed, the risks and side effects will be reviewed with you. We encourage you to try and discontinue these by your first postop appointment. Depending on your health history, you may be encouraged to take anti-inflammatories and Tylenol instead of the narcotics.
The overall risk of a complication is less than 1%. The most common risk is shoulder stiffness from scarring. Other more rare risks include, shifting of the fracture (malunion) causing screws to damage the cartilage, infection, bleeding, and painful hardware.